Gastrostomy is a surgical procedure that is done to insert a gastrostomy tube or G-tube through the abdomen and into your stomach for nutritional support.
Some facts about Gastrostomy:
- A gastrostomy is recommended if for some reason you are unable to eat enough to sustain
- A gastrostomy tube is a tube which resembles with a catheter or a button with a detachable extension and the tube have a balloon on the tip which keeps it in the correct area.
- A surgeon and a gastroenterologist work together to place the gastrostomy tube.
- The percutaneous endoscopic gastrostomy (PEG), and an open surgical procedure can be performed to place the G-tube.
Preparation for Gastrostomy:
- Medications containing aspirin or ibuprofen (Advil, Motrin IB, others) should be stopped before and after surgery as these medications may increase bleeding.
- Stop smoking if you smoke as smoking can increase your risk of having problems during and after surgery and also can slow the healing process.
- You should not eat or drink anything after midnight, the night before surgery.
- A nasogastric tube will be inserted in your nose which will go into your stomach and then an ultrasound of your stomach will be performed to check the position of your liver. It also confirms that the tube is correctly placed.
Procedure for Gastrostomy:
- Gastrostomy is usually performed under local anesthesia or moderate sedation
- You will be given an injection of glucagon hydrochloride, which temporarily paralyses the muscles in your stomach and air will be passed through the nasogastric tube and into your stomach.
- A fluoroscopy of the stomach will be performed by the interventional radiologist to determine the exact puncture site, which is usually over the middle part of the stomach.
- The gastric procedure may be carried out using CT if part of your colon or liver is in front of your stomach.
- A gastropexy, which is the fixation of the anterior gastric wall to abdominal wall will be performed by the interventional radiologist.
- A triangle on the abdominal wall will be made by using at least three anchors (T-fasteners).
- A small needle will be used by the interventional radiologist to puncture your stomach in the center of the triangle.
- The position of the needle tip within your stomach can be confirmed by injecting air or a contrast substance.
- The needle will be used to position a guidewire inside your stomach.
- Air or contrast media under imaging will be used to confirm the position of the needle tip within the stomach.
- A guidewire will be positioned through the needle and into your stomach, followed by a series of dilators which will be inserted over the guidewire to expand the area around it.
- Then the gastrostomy tube will be inserted into your stomach. The gastrostomy tube has a balloon at the end which will be inflated to keep it in place and the guidewire will be safely removed.
- A few millilitres of contrast media will be inserted through the gastrostomy tube so that the position of the tube can be checked using fluoroscopy.
- Although the procedure can be performed as an out-patient procedure in some cases, you will probably be asked to stay in hospital overnight.
